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March 11, 2011

Hydrocodone Safe For Breastfeeding Mothers

by Sam Savage

Hydrocodone, a strong painkiller commonly sold under the name Vicodin, may be safe for nursing mothers in smaller doses, according to US researchers.

Dr. Jason Sauberan of the University of California, San Diego, and colleagues found a relatively small amount of the drug ended up in breast milk, and assert that up to 30 milligrams of Vicodin per day might be acceptable if weaker pain drugs like acetaminophen do not take care of pain.

Hydrocodone is a narcotic known as an opioid. Opioids can pass into breast milk and there have been reports linking opioids to life-threatening drowsiness and one death among nursing babies.

Experts recommend that women who need painkillers due to Cesarean section or other complications during pregnancy try weaker over-the-counter drugs first. If those do not work, then they may try opioids such as hydrocodone.

And if they do take opioids, they should stick to the prescribed dose, not take them for more than three days and see a doctor immediately if the baby seems unusually sleepy or not suckling properly, Dr. Shinya Ito, of the University of Toronto, who was not involved in the new study, told Reuters Health.

For the study, the researchers measured hydrocodone and one of its by-products in breast milk from new mothers. Based on their measurements, the team estimated babies would end up with a total opioid dose of less than one percent of what is given to older infants with severe pain.

But Dr. Gideon Koren, who heads The Hospital for Sick Children's Motherisk Program in Toronto, said that estimate could be misleading because newborns keep the drug in their systems longer than older children do.

"These numbers cannot replace looking at the baby, and these numbers are not reassuring," Koren told Reuters Health by in a statement by email.